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General NPI Number Information
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NPI Number | 1699068403
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Entity Type | Organization
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Legal Business Name | SAN JOSE MOTHERS' MILK BANK
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Dates
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Enumeration Date | 05/26/2011
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Last Update Date | 04/24/2017
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Provider Practice Location Address
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Address Line | 1887 MONTEREY HWY SUITE 110
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City | SAN JOSE
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State | CA
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Zip | 95112-6117
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Country | US
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Telephone | 408-998-4550
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Fax | 408-297-9208
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Provider Business Mailing Address
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Address Line | 1887 MONTEREY HWY SUITE 110
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City | SAN JOSE
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State | CA
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Zip | 95112-6117
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Country | US
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Telephone | 408-998-4550
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Fax | 408-297-9208
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. PAULINE SAKAMOTO
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Credential |
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Telephone | 408-998-4550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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